Key result
Guideline thromboprophylaxis leaves ~14% VTE incidence in respiratory ICUs, with ECMO and cirrhosis driving proximal DVT risk.
Why the study?
Critically ill patients in ICUs are at high risk of VTE, and the prophylaxis effect under a guideline-based thromboprophylaxis protocol in a respiratory ICU needed to be explored.
Does a guideline-based thromboprophylaxis protocol prevent venous thromboembolism in critically ill patients in a respiratory ICU?
Cohort (n=884)
No
Does a guideline-based thromboprophylaxis protocol prevent venous thromboembolism in critically ill patients in a respiratory ICU?
Answers are grounded in this paper and cite their sources.
Implementation of a guideline-based thromboprophylaxis protocol in a respiratory ICU is practicable and associated with low rates of severe VTE events, though specific high-risk subgroups require additional attention.
BACKGROUND: Critically ill patients in intensive care units (ICUs) are at high risk of venous thromboembolism (VTE). This study aimed to explore the prophylaxis effect under a guideline-based thromboprophylaxis protocol among critically ill patients in a respiratory ICU. METHODS: For this single-center prospective cohort study, we followed the thromboprophylaxis protocol, which was drawn up based on relevant guidelines and Chinese experts' advice. Clinical data were entered into an electronic case report form and analyzed. Multivariate logistic regression was conducted to explore independent risk factors of VTE event under this protocol. RESULTS: From August 1, 2014, to December 31, 2020, 884 patients underwent thromboprophylaxis according to this protocol; 10.5% of them received mechanical prophylaxis, 43.8% received pharmacological prophylaxis, and 45.7% received pharmacological combined with mechanical prophylaxis. The proportion of VTE events was 14.3% for patients who received the thromboprophylaxis protocol, of which 0.1% had pulmonary thromboembolism (PTE), 2.0% had proximal deep vein thrombosis (DVT), and 12.1% had isolated distal DVT. There was no significant difference between different thromboprophylaxis measures. Cirrhosis (OR 5.789, 95% CI [1.402, 23.894], P = 0.015), acute asthma exacerbation (OR 39.999, 95% CI [4.704, 340.083], P = 0.001), and extracorporeal membrane oxygenation treatment (OR 22.237, 95%CI [4.824, 102.502], P < 0.001) were independent risk factors for proximal DVT under thromboprophylaxis. CONCLUSIONS: The thromboprophylaxis protocol based on guidelines applied in the ICU was practicable and could help decrease the proportion of PTE and proximal DVT events. The risk factors of VTE events happening under the thromboprophylaxis protocol require more attention. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02213978.
No takes yet. Share an insight, caveat, or question.
Tang et al. (2022) conducted a cohort in Critically ill patients at high risk of venous thromboembolism (VTE) (n=884). Guideline-based thromboprophylaxis protocol was evaluated on Newly developed VTE events during the ICU stay. Among critically ill patients in a respiratory ICU receiving a guideline-based thromboprophylaxis protocol, the overall incidence of VTE was 14.3%, with cirrhosis, acute asthma exacerbation, and ECMO identified as independent risk factors for proximal DVT.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: